The older adult population (65+) is the fastest growing segment of the American population and is expected to grow from 12% to 21% of the US population over the next 20 years 1. As people live longer, the prevalence of debilitating, diseases such as Alzheimer's disease and dementia will also increase. The cognitive decline associated with dementia often leads to impaired functioning with activities of daily living (ADL) with a resultant increased burden for health and social support services currently approaches $100 billion annually in the United States.1 Attempts to minimize the demand for human support services have resulted in research investigating the use of assistive technology to support independence. These systems generally incorporate sensors and/or video surveillance techniques to remotely monitor the health and behavior of seniors. However, this population is still underserved by existing technology's ability to detect the required amount of prompting needed and provide coaching on activities of daily living in a respectful, non-invasive manner. Consistent with NIA's mission and research priorities, CreateAbility Concepts, Inc.'s (CCI) will produce the SMART (Sensor Monitoring and Acuity Recognition Technology) prompt system. The hypothesis for Phase I is that variable prompting technology can successfully aid in the completion of tasks associated with ADLs for individuals with cognitive impairments. The Specific Aims CCI will use to test this hypothesis are: 1): Design and develop the computer vision and integrate and test the prototype subsystems to support the pilot study, and 2) Using a pilot study, determine whether variable prompting will improve the functional task performance for older adults with dementia. At the conclusion of Phase I, CCI will have data from a pilot study with 60 participants to support the premise that older adults with dementia can independently complete tasks of varying complexities when a human administrator assesses their need based on the participant's task performance and supplies the correct level of detail to the participant. Market acceptance is expected to be high due to the pent up demand and cost- effective offering. PUBLIC HEALTH RELEVANCE: In this SBIR project, CreateAbility Concepts, Inc. will develop technology to support and improve quality of life, well-being, and the ability of older adults to live independently and safely at home. SMART-prompt will detect and monitor an individual's task performance throughout the day and deliver person-centered prompting instructions to complete activities of daily living.